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March 2014

Ocular Safety of Recreational Lasers

Author Affiliations
  • 1Department of Ophthalmology, Duke University Medical Center, Durham, North Carolina
JAMA Ophthalmol. 2014;132(3):245-246. doi:10.1001/jamaophthalmol.2013.5647

High-powered recreational lasers with the potential to cause severe ocular injuries are becoming increasingly available to the general public. Recently, a 9-year-old boy presented to our clinic with bilateral vision loss after playing with an adult who directed a handheld laser into both of his eyes. Known as the Spyder III Pro Arctic, the device was a class 4, high-powered 1250 mW laser that is manufactured from the 445 nm blue diode of a dismantled home theater projector and that is commercially available for online purchase from overseas. On initial examination, the patient’s vision was 20/126 in the right eye and 20/100 in the left. Dilated funduscopic examination revealed preretinal hemorrhages in the macula of both eyes (Figure, A). Cross-sectional images obtained by spectral-domain optical coherence tomography demonstrated both hemorrhages to be subhyaloid- or subinternal-limiting membrane in location (Figure, B). Fortunately, the patient’s vision gradually returned to 20/20 in the left eye after a week and to 20/25 in the right eye after 2 months, with corresponding improvement in the preretinal hemorrhages in both eyes (Figure, C). Fundus autofluorescence images revealed no evidence of damage to the retinal pigment epithelium or Bruch’s membrane (Figure, D).